MEDICARE: SUSAN SABOGAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst
2	101YM0800X	Mental Health Counselor	MH27866	FL

General Provider Information

NPI Number	:	1326430521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN SABOGAL

Provider Business Mailing Address
First Line	:	7853 COLONY LAKE DR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-1303
Country	:	US
Telephone Number	:	561-318-3628
Fax Number	:

Provider Business Practice Location Address
First Line	:	7853 COLONY LAKE DR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-1303
Country	:	US
Telephone Number	:	561-318-3628
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2015
Last Update Date	:	06/05/2026

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Directions to “ SUSAN SABOGAL ” Practice Location

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